Mayo Clinic Minute: Do cholesterol medications work for older people?

July 18, 2017

The risk of having a heart attack or stroke increases with age. Having high cholesterol is a known risk factor, and many people over 65 are on statins, which are cholesterol-lowering medications. Dr. Stephen Kopecky, a Mayo Clinic cardiologist, says statins are beneficial for a large number of older people, especially those with known cardiovascular disease or those at high risk. However, the medication may not always be the best option for others.

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Should people 65 or older take statins to lower their cholesterol?

“The ones that get the highest risk for heart attacks and strokes are, guess who: elderly. So we’ve assumed that they would be better off getting a statin.”

But Dr. Stephen Kopecky says if older people don’t have heart disease, they might not need cholesterol-lowering drugs.

The American Heart Association guidelines say older people should take statins if they have known cardiovascular disease, low-density lipoprotein (LDL) cholesterol of 190 or over, or are at high risk.

When Dr. Kopecky talks to older patients who, according to guidelines, may not need statins, he says …

“... there’s two things you can do. One, you can change your lifestyle, because you’re smoking, you’re overweight, you’re not eating fruits and vegetables and you’re not very active physically. Or we can get you on a statin. To me, it’s a no-brainer. If you can change your lifestyle, it’s so much better than just taking a pill. A lot of patients think, ‘Well, if I take the pill, I can still do the lifestyle I want,’ and that’s just not true.”

He says research shows statins don’t work as well if you have bad eating habits and are sedentary. Talk to your doctor about whether or not you should be on a statin.